2022/01/17 Anser Advisory Management, LLC (11)ANSERAD.()l TWANYOIKEACOfrTD"CERT!FICATE OF LIABILITY INSURANCE DATE{MM/DOryTYY)
1t15t2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THEISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLOER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSI.JRED provisions or be endorsed.lf SUBROGATION lS WAIVED, subject to the lerms and conditions ol the policy, certain policies may require an endorsement. A statement onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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EiHLESS admin@amesgough.com
INSURER(S) AFFORDING COVERAGE
INSURED rNsunen e ,Continental lnsurance Company A(XV)
trsuaeac,Val Fo lnsurance Company A(XV)
lx5upgp4; National Fire lnsurance Company of Harfford A(XV)
rNslrRER D :Evanston lnsurance com
20508
20474
35289
Ames & Gough
8300 Greensboro Drive
Suite 980
Mcl-ean, VA22102
Anser Advisory Management, LLC
2577 North Main Street
Suite 400
Santa Ana, CA 32705
lJ3,''.L, .,,), (zos) ezz-zzzz
35378
REVISION NUMBER
TH]S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAI/1ED ABOVE FOR THE POLICY PERIODINDICATED, NOTWITHSTANDING ANY REOUIREIMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTOWHICH THIS
CERTIFICATE I\,,IAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDIT]ONS OF SUCH POLICIES, LII\,{ITS SHOWN [,lAY HAVE BEEN REDUCED BY PAID CLAIMS,
LIMITS
1,000,000
15,000
1,000,000
2,000,000
COIII!MERCIAL GENERAL LIAB LITY
70114'11355 1012612021
PERSONAL & ADV INJLJRY
GENERAL AGGREGATE
A x
x ?BEMISES lEa odrEncel $MS lvlADE DAI,IAGE TO RENTED111712023
MEo ExP (Any o.e peEof) $
PRODUCTS COMP/OP AGG $
GEN L AGGREGATE LII\lITAPPLIES PER
2,ooo,ooo
EACH OCCURRENCE
[x 59".; T] .."
OWNEO
AUTOS ONLY
HIRED
1,000,000
70114't't369 '10t26t2021
SCHEDULED
NON OWNEO
A
x
s
I
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AUTOMOBILE L1AAILITY COMBINED SINGLE LIM T
LEaaccidentl
'l/1712023 66611y NJURy (per person)
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701165238'l
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CLAIMS MADE
UMBRELLA LIAB
EXCESS L|AA
10,000,000
10,000,000AGGREGATE
s
EACI,] OCCURRENCE
C woRKERs coMPENsafloNAND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNEF/EXECUTIVEOFFCEFYMEMBER EXCLUDED?(mendatory rn NH)
ll yes descr be underDESCRIPTION OF OPERATIONS beIo,
1,000,000
1,000,000
1,000,000
70'l'i4'11386
I
S
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1117t2022 ',11712023 E L EACH ACCIOENT
E L DISEASE POLICY LIMIT
E L DISEASE FA EMF
D MKProfessional Liab LV7PL0005111 2,000,000
OESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORO 101, Addnional Remark5 Schedule, m.ybe atlached lf more spece ls requlred)RE: CIP 21.13, MCCALL BOULEVARD RESURFACING (ENCANTO. OAKHURST)
The City of Menifee, CA and its officers, employees, agents, and authorized volunteers are included as additional insured with respect to General Liability,
Automobile Liability and lJmbrella Liability when required by written contract. General Liability includes Additional lnsured coverage for On-coing &
Completed Operations as required by written contract. General Liability and Automobile Liability are primary and non-contributory over any existing
insurance and limited to liability arising out of the operations of the named insured and when required by written contract. General Liability, Automobile
Liability and Workers Compensation policies include a waiver of subrogation in favor ot the additional insureds where permissible by state law and when
SEE ATTACHED ACORD 10,1
City of Menifee, CA
29844 Haun Road
Menifee, CA 92586
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEO BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREO IN
ACCOROANCE WITH THE POLICY PROVISIONS,
AUTITORIZED REPRESENTATIVE
#*.9/*
CERTIF H LD CANCELLATION
@ 1988-2015ACORD CORPORATION. All rights reserved
The ACORO name and logo are registered marks of ACORD
ACORD 25 (2016/03)
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111712022 111712023 PerClaim/Aggregate
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A1\
AN.rss a Goucu
2022
RE: Requesting Emails for Certificate of lnsurance Distribution or Notification to Discontinue
Dear Certificate Holder:
Based on the trends from 2020 and 2021, several companies are transitioning into remote work on a more
permanent basis. ln order to maintain a successful delivery system for certificates of insurancer Ames & Gough
has decided the most efficient method to be email distribution upon renewal.
To ensure a timely delivery, we request that you provide an email to be added to the certificate on file
Project name or reference if applicable
Email address for future delivery
Certificate is no longer needed
Email: ad min @a mesgough.com
FaY703-827-2279
Please contact Allison Buytenhuys a|703-827 -2277 or abuWenhuvs@a messoush.com with any questions. Thank
you.
Sincerely,
li-100 (irocrrsbof() I)fi\c. Suilc 91t0. i\'lcl.can. Virginia 22102
IclcphoDc: (701) 817-2277 l:ircsirnilc: (701) ltlT-217()
l:-NlLlil: ioli)'rr urncsgoLrgh.conl
Ames & Gough
ANSlittAl)-01
Please either write on the attached certificate of insurance with your information, OR provide the holder name,
address and any project or reference numbers directly below:
lnsured na me:
Certificate holder name:
Return whichever form you have completed via email or fax listed below. This information can also be found on
the upper right-lrdnd corner of the certificate.